1699377663 NPI number — COMPLETE CHIROPRACTIC HEALTH OF ALLISON PARK PC

Table of content: DR. MICHELLE SOPHIA FLORES MD (NPI 1710025168)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699377663 NPI number — COMPLETE CHIROPRACTIC HEALTH OF ALLISON PARK PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPLETE CHIROPRACTIC HEALTH OF ALLISON PARK PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699377663
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/09/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4655 WILLIAM FLYNN HWY
Provider Second Line Business Mailing Address:
SUITE 125A
Provider Business Mailing Address City Name:
ALLISON PARK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15101-2488
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-684-1982
Provider Business Mailing Address Fax Number:
724-779-0003

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4655 WILLIAM FLYNN HWY
Provider Second Line Business Practice Location Address:
SUITE 125A
Provider Business Practice Location Address City Name:
ALLISON PARK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15101-2488
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-779-0001
Provider Business Practice Location Address Fax Number:
724-779-0003
Provider Enumeration Date:
11/13/2020

Additional Information

Authorized Official

Authorized Official Last Name:
MANES
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
412-681-1982

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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